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Lindberg NE, Kynø NM, Feragen KB, Pripp AH, Tønseth KA. Parental Stress, Infant Feeding and Well-being in Families Affected by Cleft Lip and/or Cleft Palate: The Impact of Early Follow-up. Cleft Palate Craniofac J 2024:10556656241231524. [PMID: 38384126 DOI: 10.1177/10556656241231524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To document the impact of early follow-up by specialized cleft nurses (SCNs) provided to families affected by cleft lip and/or palate (CL/P) and the status of parental stress, infant feeding and well-being. DESIGN Prospective inclusion of a control group, which only received standard care, followed by an intervention group that also received early SCN follow-up. SETTING The cleft lip and palate team at Oslo University Hospital, Norway. PARTICIPANTS Seventy families (69 mothers and 57 fathers) distributed into an intervention group (n = 32) and a control group (n = 38). INTERVENTION SCNs provided a consultation at the maternity ward and a follow-up conversation by phone or face-to-face at scheduled times for six months. OUTCOME MEASURES Parental Stress Index (PSI), Perceived Stress Scale (PSS-14), feeding questionnaire, survey of infant diets, weight percentiles. RESULTS The mothers reported higher stress scores than the fathers, but in the control group only in the PSI parent domain at T2 and T3 (P = .007, P = .018). Infants in the intervention group used pacifiers less frequently than in the control group (55.2% vs. 81.1%, P = .023). Otherwise, no significant differences were found between the groups. Overall, the infants received less breast milk than norms. CONCLUSION Contextual strategies for early follow-up of families affected by clefts need to be developed, with an emphasis on involving fathers and those parents reporting elevated stress and/or feeding difficulties. There is a need for diagnosis-specific guidelines about the use of pacifiers as well as collaboration between the health professionals involved to increase breastmilk feeding.
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Affiliation(s)
- Nina Ellefsen Lindberg
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nina Margrethe Kynø
- Department of Nursing and Health Promotion, Acute and Critical illness, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kim Alexander Tønseth
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Gallego Sobrino R, Iglesia-Altaba I, Moral I, Iso I, Delso E, Rodríguez G. Growth trajectories in children with cleft lip and/or palate. NUTR HOSP 2023; 40:717-723. [PMID: 37334810 DOI: 10.20960/nh.04620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Introduction Introduction: the nutritional status and growth of children with cleft lip and/or palate (CL/P) can be affected due to feeding difficulties caused by their anatomy and the surgical interventions. Objective: this retrospective longitudinal study aims to analyse the growth trajectories of a cohort of children with CL/P and compare them with a healthy representative cohort of children from Aragon (Spain). Methods: type of cleft, surgical technique and sequelae, and weight, length/height and body mass index (BMI) (weight/height2) at different ages (0-6 years) were recorded. Normalized age- and sex-specific anthropometric Z-scores values were calculated by World Health Organization (WHO) charts. Results: forty-one patients (21 male, 20 female) were finally included: 9.75 % cleft lip (n = 4/41), 41.46 % cleft palate (n = 17/41) and 48.78 % cleft lip and palate (n = 20/41). The worst nutritional status Z-scores were achieved at the age of three months (44.44 % and 50 % had a weight and a BMI lower than -1 Z-score, respectively). Mean weight and BMI Z-scores were both significantly lower than controls at one, three and six months of age, recovering from that moment until the age of one year. Conclusions: the highest nutritional risk in CL/P patients takes place at 3-6 months of age, but nutritional status and growth trajectories get recovered from one year of age compared to their counterparts. Nevertheless, the rate of thin subjects among CL/P patients is higher during childhood.
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Affiliation(s)
| | - Iris Iglesia-Altaba
- Growth, Exercise, Nutrition and Development (GENUD) Research Group. Instituto Agroalimentario de Aragón (IA2). Universidad de Zaragoza
| | | | - Iván Iso
- Hospital Universitario Miguel Servet Zaragoza
| | - Elena Delso
- Hospital Universitario Miguel Servet Zaragoza
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A nationwide cohort study on growth impairment by cleft lip with or without palate. Sci Rep 2021; 11:23609. [PMID: 34880325 PMCID: PMC8655029 DOI: 10.1038/s41598-021-03052-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/23/2021] [Indexed: 11/20/2022] Open
Abstract
There are very few nationwide studies discussing the height, weight, head circumference, and dental screening of children with cleft lip with or without palate (CL/P), with most reports on this subject based on a 1900s cohort. This study aimed to characterize CL/P children in the 2000s in terms of height, weight, head circumference, and dental screening. This nationwide population-based study evaluated the National Health Insurance Service-Infants and Children’s Health Screening (NHIS-INCHS), specifically the height, weight, and head circumference of millions of children. Dental screening data, including the status of each tooth and comprehensive dental judgment, were also evaluated. Syndromic and nonsyndromic CL/P children had lower height, weight, and head circumference than no CL/P children until the age of 66–71 months. Children with cleft palate only or both cleft lip and palate showed similar results. Regarding dental screening, the primary teeth of CL/P children erupted later and fell out faster than no CL/P children. Dental caries was also more common in CL/P children. Children with CL/P had inferior general growth, regardless of palatoplasty surgery. More aggressive dental treatment was required for CL/P children due to the instability of primary teeth and tendency for caries.
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Long-term growth patterns in children born with cleft lip and/or palate. A systematic review. NUTR HOSP 2021; 38:410-417. [PMID: 33624504 DOI: 10.20960/nh.03426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: in children with cleft lip and/or palate nutritional status and growth may be impaired due to early life feeding difficulties. Objective: to review the existing literature on the nutritional prognosis during childhood of patients undergoing surgery for cleft lip and/or palate (CLP), their body composition and growth patterns from 2 to 10 years of age, and the possible effects of their early nutritional status on the long-term onset of overweight. Methods: a systematic search of growth and body composition parameters in 2-10 year-old CLP children, including cross-sectional and longitudinal studies, and using the Pubmed and Scopus databases. From the 2,983 retrieved articles, 6 were finally included. Results: two studies out of 6 were longitudinal and the other 4 were cross-sectional, including very heterogeneous samples. Weight and height were used as growth parameters in 2 studies; 2 studies used body mass index (BMI); and the remaining 2 used indexes of nutritional status derived from anthropometric measures. The studies showed discrepancies among results: 3 of them found growth differences between children with CLP and their counterparts, whereas the other 3 did not. The two longitudinal studies did not show any significant differences between the mean BMI z-scores or growth curves of cleft patients and their counterparts. When differences existed, the most affected group was that under 5 years, syndromic children, and adopted children with CL/P. Conclusions: the literature is scarce comparing growth patterns between children with CLP and controls, and results cannot confirm that children with CLP aged 2-10 years, excluding those with syndromes or belonging to vulnerable populations, have different growth patterns or a worse nutritional status than their counterparts.
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Toscano M, Burhans K, Mack LM, Henderson S, Koltz PF, Girotto JA, Thornburg LL. Prenatal Ultrasound Measurement of Fetal Stomach Size Is Predictive of Postnatal Development of GERD in Isolated Cleft Lip and/or Palate. Cleft Palate Craniofac J 2020; 58:881-887. [PMID: 33153316 DOI: 10.1177/1055665620968717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether prenatal ultrasound measurement of fetal stomach size, as a surrogate marker of fetal swallowing, is predictive of postnatal development of gastroesophageal reflux disease (GERD) in cases of isolated cleft lip and/or palate (CL/P). DESIGN This is a retrospective case-control study. The outcome of interest is postnatal diagnosis of GERD in isolated CL/P. The exposure of interest is prenatal stomach size measurement by ultrasound. SETTING The study population was selected from an academic, tertiary care center between 2003 and 2011. PATIENTS/PARTICIPANTS Cases were neonates undergoing CL/P repair during the study period. Cases with other known structural or chromosomal abnormalities were excluded. Controls were contemporary, nondiabetic neonates that matched gestational age (within one week) to cases. Each case measurement was matched ∼1:2 with control measurement. INTERVENTIONS None. MAIN OUTCOME MEASURE The primary outcome was difference in mean prenatal ultrasound measurement of fetal stomach size between cases and controls. We hypothesized that patients with postnatal development of GERD would have smaller mean fetal stomach size. RESULTS There were 32 cases including 19 patients with unilateral cleft lip and palate, 8 with unilateral cleft lip, and 4 with bilateral cleft lip and palate. Cases were noted to have smaller mean anterior-posterior and transverse fetal stomach measurements as compared to controls. This was statistically significant from 16 to 21 weeks, 25 to 27 weeks, and 28 to 36 weeks (P < .01 for all). CONCLUSIONS Prenatal ultrasound measurement of fetal stomach size as a surrogate marker of fetal swallowing is predictive of postnatal development of GERD in isolated CL/P.
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Affiliation(s)
- Marika Toscano
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Kristen Burhans
- Department of Obstetrics and Gynecology, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Lauren M Mack
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 3989Baylor College of Medicine, Houston, TX, USA
| | | | - Peter F Koltz
- St. Luke's Hospital, Maumee, Ohio, USA.,St. Anne's Hospital, Toledo, Ohio, USA
| | - John A Girotto
- Spectrum Health Medical Group, Grand Rapids, MI, USA.,24319Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - Loralei L Thornburg
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 6923University of Rochester Medical Center, Rochester, NY, USA
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Chaya BF, Chalhoub R, Jaafar R, Nahhas N, Abu-Sittah G. Prevalence of Stunting in Syrian Refugee Children With Cleft Lip and/or Cleft Palate in Time of Crisis: A Call for Intervention. Cleft Palate Craniofac J 2020; 57:1166-1170. [PMID: 32500735 DOI: 10.1177/1055665620930450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Our study aims to compare the prevalence of stunted growth in Syrian refugee children with cleft lip and/or palate (CL±CP) to other children with CL±CP of similar socioeconomic status. DESIGN A retrospective medical chart review. SETTING Center for Cleft and Craniofacial Surgery at a tertiary care hospital in Lebanon in the period between January 2013 and May 2019. PATIENTS, PARTICIPANTS One hundred three Syrian refugee children and 70 Lebanese children <18 years of low socioeconomic status who have CL, CP, or both. INTERVENTIONS These patients underwent cleft repair surgeries at our center. MAIN OUTCOME MEASURE(S) Stunted growth measured by calculating the height-for-age z-score (HAZ). RESULTS Using a confidence interval of 95%, the prevalence of stunting is significantly higher among Syrian refugees (P < .003). The prevalence of stunting and age of presentation were positively correlated (P < .02). There was no difference in stunting between patients with CP and CL (P < .746). There was no difference in stunting between genders. CONCLUSIONS The majority of Syrian refugee patients with CL±CP fall on the malnourished side of the nutritional spectrum as reflected by the high percentage of stunting as well as a mean of -1 for the HAZ.
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Affiliation(s)
- Bachar F Chaya
- Division of Plastic and Reconstructive Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Rawad Chalhoub
- Division of Plastic and Reconstructive Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Rola Jaafar
- Division of Plastic and Reconstructive Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Nour Nahhas
- Division of Plastic and Reconstructive Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Ghassan Abu-Sittah
- Division of Plastic and Reconstructive Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon
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Sundell AL, Nilsson AK, Marcusson A, Törnhage CJ. Body Mass Index and Association With Caries in School-Aged Children With Orofacial Cleft: A Case-Control Study. Cleft Palate Craniofac J 2019; 57:169-176. [PMID: 31450975 DOI: 10.1177/1055665619868862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Data on the association between body mass index (BMI) and dental caries in children with orofacial clefts are sparse. Therefore, studies on the impact of BMI on caries frequency in children with cleft lip and/or palate (CL/P) are of importance. The aim of the current study was to investigate the association between BMI and frequency of dental caries in children with and without CL/P. Height, weight, and BMI in children with CL/P were also compared to controls. DESIGN This study used a cross-sectional case-control design. PARTICIPANTS One hundred and thirty-nine 5- and 10-year-old children with CL/P and 299 age-matched controls. MAIN OUTCOME MEASURES Caries was recorded according to the International Caries Detection and Assessment System. Height and weight were recorded, and BMI was calculated as weight/height2. RESULTS There was no correlation between BMI and caries frequency. Weight, height, and BMI were significantly lower in all children with CL/P compared to controls. After adjustment for international adoption, only BMI was significantly lower in CL/P children compared to controls. Non-adopted children with CL/P were significantly heavier and longer than adopted children with CL/P. CONCLUSIONS Five- and 10-year-old children with corrected CL/P seemed to have a lower BMI than controls, but there was no association between BMI and caries frequency. Internationally adopted children with CL/P were lighter and shorter than non-adopted CL/P children and controls.
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Affiliation(s)
- Anna Lena Sundell
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden
| | | | - Agneta Marcusson
- Department of Dentofacial Orthopedics, Maxillofacial Unit, Linköping University, Linköping, Sweden
| | - Carl-Johan Törnhage
- Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden.,Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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A Pilot Study of Mothers' Breastfeeding Experiences in Infants With Cleft Lip and/or Palate. Adv Neonatal Care 2019; 19:127-137. [PMID: 30325751 DOI: 10.1097/anc.0000000000000551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite the recognized importance of human milk (HM) use, breastfeeding is often discouraged for infants with cleft lip and/or palate because of their anatomical abnormalities. Poor weight gain may require formula for calorie supplementation. Stresses associated with caring for infants with cleft lip/palate may decrease rates of HM provision to these infants. PURPOSE This study investigates the experiences of mothers of infants with cleft lip/palate (CL/P) to determine choices and factors associated with providing HM to their infants. METHODS A retrospective telephone survey was administered to a cohort of mothers of infants with CL/P. RESULTS Fifty mothers agreed to participate in the survey. Most (78%) initiated use of HM for a median duration of 4 months, 32% provided HM for 6 months or more, and 79% exclusively expressed their HM. Poor supply was the most frequent challenge to providing HM and led to cessation in 46% of the mothers. Formula was used to supplement for poor supply or poor infant weight gain in 90% of the mothers. The best predictors of a mother's use of HM were child not in day care, genetic diagnosis, and gestational age at birth. Only 36% of mothers reported individual encouragement to provide HM, and 18% reported they were specifically discouraged from providing HM for their infants. IMPLICATIONS FOR PRACTICE Although initiation rates were high, there are opportunities to improve support for mothers to increase duration of HM provision in children with CL/P. IMPLICATIONS FOR RESEARCH This study establishes a baseline for future prospective studies looking at the impact of active encouragement and provision of lactation support within the cleft team setting.
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Woods SM, Garfinkle JS, Covell DA, Wang M, Busch LS, Doyle LM. Early Weight Gain in Infants With Cleft Lip and Palate Treated With and Without Nasoalveolar Molding: A Retrospective Study. Cleft Palate Craniofac J 2018; 56:902-907. [PMID: 30514093 DOI: 10.1177/1055665618815396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess weight gain of infants with cleft lip and/or palate (CL ± P) treated with nasoalveolar molding (NAM). DESIGN Retrospective, case-control chart review. SETTING Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon. PATIENTS, PARTICIPANTS Infants with nonsyndromic CL ± P and noncleft controls. INTERVENTIONS Prior to primary lip surgery, NAM was either included (+NAM) or not included (-NAM) in the cleft treatment protocol. MAIN OUTCOME MEASURE(S) Weight gain and percentage weight gain relative to initial weight were compared among +NAM, -NAM, and control groups from birth to 7 months and from birth to 36 months. RESULTS Comparing +NAM and -NAM groups, no significant difference in weight or percentage weight gain was found in either time window. Compared to controls, from birth to 7 months, both CL ± P groups weighed less (P < .001), while percentage weight gain was greater for the +NAM (P < .001) and did not differ for -NAM. From birth to 36 months relative to controls, weight for +NAM showed no significant difference and -NAM weighed less (P < .01), while percentage weight gain was greater for both CL ± P groups (P < .001). CONCLUSIONS Comparisons of CL ± P infants treated with and without NAM showed that with the NAM appliance, despite its added complexity, there was no adverse impact on weight gain. Comparisons to noncleft, control infants suggests that NAM treatment may have a beneficial impact on weight gain.
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Affiliation(s)
- Shannon M Woods
- 1 Department of Orthodontics, Oregon Health & Science University, Portland, OR, USA
| | - Judah S Garfinkle
- 1 Department of Orthodontics, Oregon Health & Science University, Portland, OR, USA.,2 Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA.,3 Private Practice, Portland, OR, USA
| | - David A Covell
- 4 Department of Orthodontics, University at Buffalo, Buffalo, NY, USA
| | - Mansen Wang
- 5 Medical Data Research Center, Providence Health Services, Portland, OR, USA
| | | | - Larry M Doyle
- 1 Department of Orthodontics, Oregon Health & Science University, Portland, OR, USA
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Baylis AL, Pearson GD, Hall C, Madhoun LL, Cummings C, Neal N, Smith A, Eastman K, Stocker C, Kirschner RE. A Quality Improvement Initiative to Improve Feeding and Growth of Infants With Cleft Lip and/or Palate. Cleft Palate Craniofac J 2018; 55:1218-1224. [DOI: 10.1177/1055665618766058] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective: The purpose of this quality improvement initiative was to improve feeding and growth outcomes in infants with cleft lip and/or palate (CL/P). Design: Institute for Healthcare Improvement quality improvement model. Setting: Large pediatric academic medical center in the Midwestern United States. Participants: One hundred forty-five infants with nonsyndromic CL/P ages 0 to 12 months. Interventions: Key drivers included (1) caregiver education and resources, (2) care coordination and flow, and (3) provider education and training. Interventions were designed around these themes and included targeting improved team communication, increased social work consultations, patient tracking, staff education, improved access to feeding equipment, and the launch of a new cleft palate feeding team. Main Outcome Measure(s): The primary outcome measure was the percentage of new patients with CL/P who met criteria for failure to thrive (FTT) per month. The secondary outcome measure was the frequency of hospitalization for infants with CL/P with a primary reason for admission of feeding difficulties or FTT. Results: The institutional FTT rate for infants with CL/P decreased from 17% to 7% ( P < .003). The frequency of hospitalization for FTT improved from once every 30 days to once every 118 days. Conclusions: Targeted interventions aimed at improving feeding efficiency and effectiveness, as well as changes in care delivery models, can reliably promote improvements in feeding and growth outcomes for infants with CL/P, even with psychosocial risk factors present.
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Affiliation(s)
- Adriane L. Baylis
- Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University College of Medicine, OH, USA
| | - Gregory D. Pearson
- Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University College of Medicine, OH, USA
| | | | - Lauren L. Madhoun
- Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Speech and Hearing Sciences, The Ohio State University, Columbus, OH, USA
| | - Caitlin Cummings
- Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Speech and Hearing Sciences, The Ohio State University, Columbus, OH, USA
| | - Nancy Neal
- Nationwide Children’s Hospital, Columbus, OH, USA
| | - Amanda Smith
- Nationwide Children’s Hospital, Columbus, OH, USA
| | | | | | - Richard E. Kirschner
- Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University College of Medicine, OH, USA
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Crês MC, Marques IL, Bettiol H. Evaluation of Delayed Puberty in Adolescents with Cleft Lip/Palate. Cleft Palate Craniofac J 2016; 53:464-8. [DOI: 10.1597/14-175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To assess the frequency of delayed puberty in adolescents with cleft lip and/or cleft palate (CL/P). Design This was a cross-sectional study of 203 patients with CL/P and no associated syndromes treated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. We evaluated boys aged 14-19 years and girls aged 13-18 years. The patients were classified according to Tanner stages of sexual development. The age of menarche was recorded. Patients were assigned to three groups according to cleft type: isolated cleft lip (CL), cleft lip and palate (CLP), and isolated cleft palate (CP). The results were expressed as frequencies and averages and compared with pubertal changes described for typically developing adolescents as reported in the literature. Results Subjects were 115 boys and 88 girls. All boys in the CL group and the CP group had already started puberty, and two boys in the CLP group (2.3%) had delayed puberty. All girls had started puberty. The average age at menarche was 12.3 years in the CL group, 12.1 years in the CLP group, and 12.5 years in the CP group. Conclusions The frequency of delayed puberty and the average age at menarche in adolescents with CL/P and no associated genetic syndromes or anomalies were within the expected range for typically developing adolescents (i.e., those without CL/P) in the same age group.
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Affiliation(s)
- Maria Cristina Crês
- Pediatrician Endocrinologist, Hospital Estadual Bauru, FAMESP/Organização Social de Saúde, Bauru, Brazil
| | - Ilza Lazarini Marques
- Pediatrician and Director of Medical Service, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Heloisa Bettiol
- University of São Paulo, Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, Brazil
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AbdollahiFakhim S, Bayazian G, Shiva S, Sohrabpour M, Ebrahimzade Y. Growth hormone deficiency in cleft lip and palate patients. JOURNAL OF ANALYTICAL RESEARCH IN CLINICAL MEDICINE 2015. [DOI: 10.15171/jarcm.2015.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Noorazar SG, Ranjbar F, Nemati N, Yasamineh N, Kalejahi P. Relationship between severity of depression symptoms and iron deficiency anemia in women with major depressive disorder. JOURNAL OF ANALYTICAL RESEARCH IN CLINICAL MEDICINE 2015. [DOI: 10.15171/jarcm.2015.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Marques IL, Nackashi J, Borgo HC, Martinelli APMC, De Souza L, De Cássia Rillo Dutka J, Williams WN, Pegoraro-Krook MI. Longitudinal Study of Growth of Children with Unilateral Cleft Lip and Palate: 2 to 10 Years of Age. Cleft Palate Craniofac J 2015; 52:192-7. [DOI: 10.1597/13-161] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To study the growth of children with complete unilateral cleft lip and palate (UCLP) from 2 to 10 years of age and to assess whether growth varied from that of children without UCLP (typical children). Design Physical growth was one of the outcome measures of a National Institutes of Health–sponsored longitudinal, prospective clinical trial conducted by the University of Florida and the University of São Paulo. Setting Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP), Bauru, Brazil. Main Outcome Measures Height and weight were prospectively measured for 360 healthy children with UCLP who were nonsyndromic, belonged to median socioeconomic status, and received health care at HRAC-USP. To compare growth of children with UCLP to that of typical children, growth curves for UCLP were developed and compared with World Health Organization curves for 2006 and 2007, which were used as reference for typical children. Third-degree polynomials were used to explain the relationship of length and weight with age. Confidence limits of 95% were used for the mean curve using the statistic Z ~ N (0,1). Results Children with UCLP from 2 to 10 years old presented height and weight growth curves similar to those of typical children for both genders. Conclusion Children with UCLP from 2 to 10 years old presented physical growth similar to that of typical children.
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Affiliation(s)
- Ilza Lazarini Marques
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - John Nackashi
- University of Florida, College of Medicine, Gainesville
| | - Hilton Coimbra Borgo
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | | | - Luiz De Souza
- University of São Paulo, College of Medicine, Ribeirão Preto, SP, Brazil
| | - Jeniffer De Cássia Rillo Dutka
- Communication Disorders Department, School of Dentistry of Bauru and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - William N. Williams
- Communication Disorders Department, School of Dentistry of Bauru and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Maria Inês Pegoraro-Krook
- Communication Disorders Department, School of Dentistry of Bauru and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
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Miranda GS, Marques IL, de Barros SP, Arena EP, de Souza L. Weight, Length, and Body Mass Index Growth of Children Under 2 Years of Age With Cleft Lip and Palate. Cleft Palate Craniofac J 2015; 53:264-71. [PMID: 25554856 DOI: 10.1597/14-003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the growth of length-for-age (L/A), weight-for-age (W/A), and body mass index (BMI) of children with cleft lip and palate receiving a normal diet; to establish specific growth curves for children with cleft palate with or without cleft lip (CLP/ICP) who had not undergone palatoplasty and for children with isolated cleft lip (ICL); and to assess if CLP/ICP growth differed from ICL growth and if CLP/ICP and ICL growth differed from growth for typical children. DESIGN Prospective and cross-sectional study. SETTING Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil. MAIN OUTCOME MEASURES Weight and length of 381 children with cleft lip and palate and who were younger than 2 years were recorded and used to calculate W/A, L/A, and BMI growth curves. The 2006 World Health Organization growth charts were used as a reference for typical children. All children received a normal diet for age. RESULTS Children with CLP/ICP had median W/A and BMI growth curves below growth curves for typical children but showed spontaneous recovery starting at approximately 5 months of age, even with nonoperated cleft palate. Children with ICL had growth similar to that of typical children. Children with CLP/ICP, who initially had W/A and BMI values less than those of the ICL group, had W/A and BMI equal to or higher than the ICL group after 9 months of age. CONCLUSION Children with CLP/ICP had impaired W/A and BMI growth with spontaneous recovery starting early in childhood. This study established specific W/A, BMI, and L/A growth curves for children with cleft lip and palate.
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Gil-da-Silva-Lopes VL, Monlleó IL. Risk factors and the prevention of oral clefts. Braz Oral Res 2014; 28 Spec No:1-5. [DOI: 10.1590/s1806-83242014.50000008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 12/10/2013] [Indexed: 11/22/2022] Open
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Gil-Da-Silva-Lopes VL, Xavier AC, Klein-Antunes D, Ferreira ACRG, Tonocchi R, Fett-Conte AC, Silva RN, Leirião VHV, Caramori LPC, Magna LA, Amstalden-Mendes LG. Feeding Infants with Cleft Lip and/or Palate in Brazil: Suggestions to Improve Health Policy and Research. Cleft Palate Craniofac J 2013; 50:577-90. [DOI: 10.1597/11-155] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To verify feeding resources used prior to corrective surgery among cleft babies from Brazil and to discuss suggestions to improve common feeding problems around the world. Design Cross-sectional descriptive study conducted at eight medical centers. Participants A total of 215 parents or guardians of cleft children. Methods Interview based upon a prevalidated questionnaire. The chi-square test and comparison of means by analysis of variance were used; significance level adopted was 5% ( P < .05). Results Feeding guidelines were provided in the maternity unit to 53% of the families. Breastfeeding was encouraged among 80% of mothers, predominantly in the South ( P = .016). However, follow-up after maternity discharge was not appropriately carried out and failure to breast-feed occurred in 78% of families. The feeding tube was used in 21%. According to families, for those who used the ordinary nipple, it was considered the best option by the majority (29%). Conclusion Neonatal feeding in cleft babies is a global challenge. Reports about the difficulties encountered and successful experiences would be helpful to disseminate strategies and stimulate research directed at the large-scale applicability of neonatal feeding for cleft babies on public health. This study detected the need to increase professional training and emphasizes the need for public policies addressing neonatal referral to specialized care wherever possible. It also stimulates research into using an ordinary nipple as another resource for feeding cleft babies and suggests an international discussion about specific recommendations for humanized primary health care.
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Affiliation(s)
| | | | | | | | - Rita Tonocchi
- Centro de Atendimento Integral ao Fissurado, Associação de Reabilitação e Promoção Social ao Fissurado Labiopalatal, Curitiba, Brazil
| | - Agnes C. Fett-Conte
- Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | | | | | | | - Luiz A. Magna
- Department of Medical Genetics, University of Campinas, Campinas, Brazil
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Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates. PLASTIC SURGERY INTERNATIONAL 2012; 2012:973240. [PMID: 23304489 PMCID: PMC3523602 DOI: 10.1155/2012/973240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 11/13/2012] [Indexed: 11/18/2022]
Abstract
Goals/Background. To evaluate children's growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF), in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO) regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50) and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care.
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